Implementation Science of Paediatric Palliative Care in Lower-Middle-Income Countries in Southeast Asia: An Integrative Review.

There is an ongoing development in the paediatric palliative care (PPC) program in Southeast Asia (SEA). However, the implementation process has not been clearly understood among lower-middle-income countries (LMICs) in this region. The purpose of this paper is to review and synthesise research about the implementation process of 7 identified LMICs in the SEA: Cambodia, Indonesia, Myanmar, Lao PDR, the Philippines, Timor-Leste, and Vietnam. An integrative review utilising Whittemore and Knafi's five-stage process was employed. Electronic searches of CINAHL, Web of Science, ProQuest, and Google Scholar (no year restriction) were conducted. From the 7599 articles retrieved, only 11 met the eligibility criteria. Each article was appraised for methodological quality (QualSyst tool and AACODS checklist) and constant comparison methods were used. Two overarching themes emerged in this review - the gaps in PPC standards, practice framework, and guidelines and the PPC challenges and implementation strategies. Understanding the implementation science of PPC among LMICs in the SEA region addresses the gap between idealism and realism. It provides reliable information in the development of strategic work plans that will improve the implementation process and promote the translation of EBIs into practice significant to the quality of paediatric patient outcomes.

Significance of Home Visiting in Providing Care to Filipino Mothers and Their Infants During the Postpartum Period.

INTRODUCTION: Home visiting is recommended for mothers and young infants during the first week of life to provide needed support. This study describes the significance of home visiting in providing care to Filipino mothers and their infants during the postpartum period. METHODOLOGY: Using a descriptive qualitative design, individual interviews were conducted with 10 mothers, four registered nurses, and five barangay health workers involved in home visits. Data analysis was guided by the four phases of Leininger's ethnonursing method. RESULTS: Three themes emerged: (1) home visiting provides accessible, affordable, and meaningful interventions; (2) home visiting allows for contextual understanding of mothers' behaviors and realistic planning of care; and (3) barangay health workers promote mothers' engagement in care. CONCLUSION: Home visits enable negotiation of differences between generic and professional care practices, thus enhancing professional collaboration with families and community workers, potentiating culturally congruent participation and empowerment of clients in their care.

The role of Ayod community health teams in promoting maternal and infant health in a Municipality in Ifugao, Philippines

OBJECTIVE: This study investigates the role of the Ifugao Community Health Teams, or the Ayods that function as frontline health workers, responsible for tracking pregnant women, bringing them to clinics for check-ups and encouraging planned facility-based birth. Specifically, this study examines their contribution to the Maternal and Child Health (MCH) Project, jointly initiated by the Philippines Department of Health (DOH) and Japan International Cooperation Agency (JICA). Commencing in 2006 and ending in 2010, the project aimed to improve the health and safety of mothers and newborns by ensuring the availability of quality health care, and increasing utilization of health facility and services.METHODS: A qualitative interpretive descriptive approach was used to guide the study. Three focus group discussions were conducted to collect data from a total of 21 participants, who were active members of the Community Health Teams in one municipality in Ifugao. To work with these data, an a priori template analysis was used to assist in identifying themes within the data.RESULTS: This study has highlighted three major themes: (1) Collaborative efforts of the Ayods play a role in the achievement of significant health outcomes for the community; (2) Equity, access and beliefs are key factors in the delivery of health care; and (3) Sustainability is secured through self-reliance and volunteerism.CONCLUSION: The engagement of Ayods to trace and support pregnant women appears to have several successful health outcomes. The employment of existing community health workers and volunteers enabled the creation of sustainable model for isolated communities. It is anticipated that this vital service will continue to be provided. Nevertheless it will require ongoing and increasing support through the provision of allowances, education and community commitment to voluntary work.